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What health reform means for the people of Illinois

A blog by IllinoisHealthMatters.org

Friday, February 19, 2016

Key Lessons from Health & Medicine’s Budget Forum

On January 15, 2016, Health & Medicine hosted a meeting of The Chicago Forum for Justice in forum proceedings notes as a reference guide for the forum’s content.

Our notes are written as a summary and while they can’t fully capture the presentations, videos of each of the five mini panels are available on the event webpage, as are slides from speakers who used them in their presentations. We thank CAN TV for recording, editing, and sharing videos of the forum, extending the potential impact of our panelists’ presentations.

We hope these notes will be useful for advocates and policymakers seeking to understand issues related to the budget, think about potential revenue solutions, and consider strategies, framing, and narratives likely to advance progress.  Health & Medicine will be convening a small group soon to review the forum proceedings and discuss next steps for our work on this critical area, which we’ll share on our website.

While the budget problems and solutions are more complex than this, here are some main points that have emerged for me from conversations and from the presentations and discussion at the conference:

  • Illinois lacks sufficient revenue, which represents a structural budget problem, priming the State to have recurring budget shortages and hampering our ability to provide Illinoisans with the public services they need and want, thus harming the health of the public, and disproportionately harming vulnerable communities.
  • The structural budget problems have several potential revenue solutions, including a progressive income tax structure and efforts to ensure corporations pay their fair share, both of which are more equitable than our current system and would better grow revenue in proportion to the size of Illinois’ economy.
  • State elected officials are collectively responsible for passing a budget and using a selection of revenue solutions that will help preserve and improve the vital health, social, and education programs and services that support people’s health and Illinois’ economy.  Inaction on the structural revenue shortages that Illinois faces is an unacceptable abdication of the governing duties our public officials share.

Of course, these salient points are based on a range of facts and history about Illinois’ taxes and budgets, beyond the scope of this post.  A significant amount of such relevant detail is covered in the forum proceedings notes, as well as the slides and videos on the event webpage (linked to above).

Also, related to this subject, Health & Medicine’s Executive Director, Margie Schaps, had two letters focused on Illinois’ budget published in the last couple of weeks:

Wesley Epplin
Director of Health Equity
Health & Medicine Policy Research Group

Tuesday, February 16, 2016

Blacks Hit Especially Hard in Illinois Budget Impasse

February is Black History Month – and Illinois’ eighth month without a State budget. As we highlight black people’s contributions to the American narrative, the message sent by Illinois’ budget impasse is hardly celebratory.

All Illinoisans are suffering as the fragile web of supportive services slowly unravels. Communities across the state are feeling the ripple effects of layoffs, reduced services, slow State payments and the tension that comes with sustained uncertainty.

In the midst of our shared suffering, we must acknowledge this sad truth. People of color, especially black people, are enduring the deepest battle scars from this budget stalemate. And if history is our teacher, these will become the scars of future generations. America’s tortured racial history is embedded in the laws and policies that govern all of us, resulting in widening social, health and economic gaps that operating without a state budget only exacerbates.

Earlier this month, Heartland Alliance’s Social IMPACT Research Center issued a report that illustrates how pervasive these disparities are in Illinois. The study reports that despite significant dips over the past several decades, the number of Illinoisans living in poverty today, 14.4%, is almost the same as it was in the late 1960s (14.7%). While under 10% of whites in Illinois are living in poverty and Hispanic and Asian populations each have poverty rates of close to 20%, a whopping 30.6% of black people are living in poverty statewide, while making up less than 15% of Illinois’ population. And what is even more disheartening is that 43.2% of black children under the age of 17 are poor. In fact, poverty among black people outpaces that of whites, Latinos, and Asians in all age categories.

The report lays out a number of health and economic disparities by race. But what is at least as important as the data is the case the authors lay out for the “legacy of inequality” that colors public policy in America. The report offers a historical soundbite of the legalized racist policies of the past that benefited whites and created barriers for people of color, policies and practices that ignore the generational impact of those benefits and barriers, and the practice of mid-twentieth century redlining that seems to have intertwined race, ZIP code and opportunity into perpetuity.

This budget impasse threatens any progress made towards reducing inequalities in Illinois. For example, last year, for the first time in decades, Chicago saw fewer than 1,000 new HIV cases. That does not happen without a network of community organizations and institutions focused on communities hardest hit by the epidemic — black bisexual and gay men, transgender women of color, and black heterosexual women living in communities with high HIV rates. Blacks make up only 15% of the State’s population but account for 50% of new HIV cases. Yet, the governor’s proposed budget includes a devastating 66% cut to the African-American HIV/AIDS Response Act, a dedicated line of HIV funding that supports the black community, the community hardest-hit by HIV. This at a time when an estimated 6,525 Illinoisans do not know their HIV status and nearly 50% of people living with HIV in this State are not receiving any medical care or HIV medications.

One thing is abundantly clear this Black History Month in “the land of Lincoln:” Elections have consequences. We must continue to put pressure on the Governor and our state Legislature to approve a humane budget with a revenue increase even as we prepare ourselves for the next budget battle. As the late poet Maya Angelou often said, “When you know better, you do better.” We can do a lot better, Illinois.

This article was originally posted on RebootIllinois.com.

Kim Hunt
Executive Director, Pride Action Tank
AIDS Foundation of Chicago

Tuesday, February 2, 2016

Food Keeps Illinois Families Healthy: Help Illinois Reduce the SNAP Gap

Forty-eight million Americans live in food insecure households, meaning they worry about where and how to find their next meal. Many of these individuals and families are covered by Medicaid but are not receiving critical nutritional support. They are eligible for SNAP which could help support their nutrition and improve their health, but they are not enrolled.

What is SNAP?

The Supplemental Nutrition Assistance Program (SNAP, formerly Food Stamps) helps low-income households purchase adequate, nutritious food. Benefits are distributed monthly on an Electronic Benefits Transfer card, known as “Link” in Illinois, which acts much like a debit card. Money from SNAP can be spent at authorized retailers, and some farmers markets, on any foods that recipients prepare and eat at home. SNAP recipients nationally spend over 85 percent of benefits on fruits and vegetables, grains, dairy, meat and meat alternatives. Beneficiaries also increase the amount of money they spend on groceries each month, instead of simply replacing their food budget with SNAP dollars. By supplementing, not replacing, grocery budgets and allowing for the purchase of more nutritious food, SNAP reduces food insecurity in low-income households. This is particularly true of households with children.

Why Help Consumers Apply for SNAP Benefits?

Connecting more Medicaid recipients with SNAP benefits can address food insecurity and inadequate nutrition, which this population experiences at high rates, and improve health outcomes. In addition to helping a family afford healthier food, children who receive nutrition supports are healthier and more likely to finish school while participating in the program. A report recently released by the White House Council of Economic Advisers details the long-term benefits of this program, including: for mother’s receiving support during pregnancy, reductions in incidences of low birth-weights; and for adults who received support when they were children, reductions in obesity rates and metabolic syndrome, increased likelihood of having completed high school, and significant improvements in overall health and economic self-sufficiency among women.

New Opportunities in Illinois to Reduce the SNAP Gap

The Affordable Care Act has made it easier for low-income individuals and families to access public benefits by helping states pay for electronic systems to apply for benefits. In Illinois, the new Application for Benefits Eligibility enables applicants to submit a single application for both SNAP and Medicaid. However, despite this improved online application, we have not fully reduced the “SNAP Gap”—the number of Medicaid clients who are income-eligible for SNAP but do not receive this benefit.  We need to work with medical providers, medical plans, social service organizations and other partners to make sure that everyone who is eligible for SNAP gets the help they need to pay for healthy food.

The newest change to the Illinois SNAP program is that on January 1, 2016, Illinois raised the gross income limit for SNAP from 130% to 165% of the federal poverty level, making nearly 40,000 low-income working families newly eligible for SNAP. With more families in Illinois now eligible for SNAP and the ability to submit a single application for both SNAP and Medicaid benefits, it’s time to close the SNAP Gap and make sure families have the food they need to stay healthy. If you’re not familiar with SNAP’s application process join us on HelpHub for more information and resources for both providers and consumers.

MacKenzie Speer
Advocacy Program Associate
Sargent Shriver National Center on Poverty Law